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Published on: March 24, 2020
Long-term study of accommodative esotropia
Irene H Ludwig1, Susan P Imberman, Hilary W Thompson
1LSU Eye Center, New Orleans, Louisiana, USA.
Purpose:
This study aimed, using a large sample size, to determine the long-term results of standard treatment of accommodative esotropia and identify predictors of outcome while minimizing bias in data collection and analysis.
Methods:
Data from all the files of a large, long-established pediatric ophthalmology practice were collected and analyzed using a masked protocol. The study included every esotropic patient who had been prescribed glasses. Criteria for patient inclusion were designed to conform to earlier studies by the authors.
Results:
The database totaled 1307 patients, of who 354 met inclusion criteria. A greater difference between near and distance esodeviation (AC/A relationship) correlated with a higher rate of deterioration of accommodative esotropia control (P < 0.0001). Deterioration also positively correlated with earlier age of onset (P < 0.0001), inferior oblique overaction (P = 0.0005), and amblyopia (P < 0.005).
Conclusions:
This study demonstrates that a high AC/A relationship increases the likelihood of deterioration of accommodative esotropia, supporting the earlier studies, as well as the accuracy of this database. It also represents a new model for the utilization of clinical trials' bias-reduction principals in the analysis of retrospective data.
